That was the message from several speakers at the inaugural National Health IT Day in Washington last week. The event was sponsored by more than 40 public- and private-sector health care and standards organizations looking to show the potential of IT to improve health care and help control its spiraling costs.
Officials at some regional health information organizations, which have been created to facilitate the exchange of health data among local hospitals, physicians and insurers, said they face financial hurdles as they begin work on creating EMR systems.
Leisa Jenkins, executive director of CareSpark, a RHIO encompassing northeastern Tennessee and southwestern Virginia, said the organization has so far received commitments for US$2.5 million in federal grants and contributions from members and area employers to launch an EMR system. The group needs $4 million to complete that project and estimates that $1.2 million would be required to cover annual operating costs.
"If we can get over the capital expenditure in Year 1, we can break even in Year 2, and by Year 3 we should be able to show a 3-to-1 ROI," she said.
CareSpark's business model requires that managers show stakeholders the likely savings that would come from exchanging patient data electronically, she said.
Meanwhile, Glenn Steele, president and CEO of Geisinger Health System, said he's no stranger to the sometimes staggering costs of moving to an EMR system. Danville, Pa.-based Geisinger has spent $70 million since 1995 to set up and run one for its 40 hospitals, clinics and physician practices, he said.
Steele said it took some time for the effort to show its potential for cost savings -- and about five years to yield a return on the investment. For example, he said, physician practices reported a 5 percent to 10 percent reduction in productivity during the first six to eight months that the EMR system was in use. But after that, productivity increased markedly.
Geisinger now aims to update the system over the next five years to provide optimized care for patients with chronic diseases, he said.
Geisinger was able to get its 650 physicians to adopt the software early on by making it mandatory, Steele said. The health system also offered limited connectivity to the EMR system to area physicians not affiliated with Geisinger in order to show them its potential benefits and encourage them to link to it.
The health system also tapped several physicians to be advocates for the EMR technology among their colleagues, Steele said. "Without that, you are dead," he added.
Jim Morrow, vice president of North Fulton Family Medicine PC in its Cumming, Ga., office, said his practice began using EMR software in 1998 to eliminate annual data transcription costs of $110,000.
Since that successful start, the practice has realized additional savings by reducing the average number of workers needed to manage patient charts from just over four to just under three, he said. North Fulton also can now use the system to ensure that patients are receiving preventive care such as vaccines.
Morrow acknowledged that the costs -- as much as $25,000 per physician -- can be difficult to absorb. But he said doctors should move ahead with automating paper-based records on their own, or they could face government mandates in the future.
Mark McClellan, administrator of the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services, said that many health care providers presume that "health IT doesn't pay off, especially if they operate on thin margins." At the same time, most health care executives do believe that EMR systems can improve the quality of health care, he said.
Some health care providers fear that undertaking IT projects that promise significant value could lead to financial woes, McClellan said. "In health care, you often get paid less when you provide a higher level of care at a lower cost," he said, because providing better health care generally means fewer visits to the doctor, fewer tests and less medication.